Mr Senu T Sejoro
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(The following allegation was considered by a Panel of the Conduct and Competence Committee at the substantive hearing on 6 - 7 March 2017.)
While registered as a Radiographer, and employed as Sonographer at East Lancashire Hospitals NHS Trust:
1. On or around 5 May 2015 during Patient A's 20 week scan, you:
a) fell onto Patient A's abdomen;
b) applied pressure to Patient A's abdomen by pushing yourself up to your feet;
2. On the following dates, you entered the patient assessment information onto the incorrect patient's file:
a) 5 May 2015; and
b) 21 July 2015.
3. On or around 10 July 2015 in relation to Patient B, you did not:
i. complete the liquor volume and/or Doppler accurately;
ii. complete the growth test as requested;
4. On or around 27 July 2015, you did not communicate effectively with Patient C during a scan;
5. The matters set out in paragraphs 1 - 4 constitute misconduct and/or lack of competence.
6. By reason of your misconduct and/or lack of competence your fitness to practise is impaired.
1.Today’s Panel noted typographical errors on the second page of the substantive decision. It states that Particular 3(ii) was found not proved. However, paragraphs 27 and 28 of that determination make clear that it was proved. The Panel also noted that Particular 3(i) was found proved only in relation to not completing the liquor volume accurately. In addition, the earlier determination records that particular 3(iv) was proved when there was no particular 3 (iv), and does not list as proved particular 4 which along with all other factual particulars was found proved.
2.The Panel had information before it that Notice of today’s hearing dated 1 February 2019 was sent to the Registrant’s address on the register on the same date by first class post. The Panel accepted the advice of the Legal Assessor and was satisfied that service had been effected in accordance with Rules 3 and 6 of the Health and Care Professions Council (Conduct and Competence Committee) (Procedure) Rules 2003.
Proceeding in the Registrant’s Absence
3.Mr Stephens, on behalf of the HCPC, applied for the Panel to proceed today. He informed the Panel that the Registrant has not corresponded or engaged at all with regard to today’s hearing, or the previous review hearing, and had last communicated with the HCPC in 2016. Mr Stephens submitted that the Registrant has voluntarily waived his right to attend.
4.The Panel took into account the HCPTS Practice Note entitled “Proceeding in the Absence of the Registrant” and accepted the advice of the Legal Assessor. The Panel was aware that the discretion to proceed in the absence of a Registrant should be exercised with the utmost care and caution. The Panel was of the view that there is no indication that an adjournment would secure the Registrant’s attendance at a future date given the lack of a response or request for an adjournment from the Registrant. The Panel noted that the Registrant has not engaged with the HCPC since his email on 30 August 2016 stating that he would not be attending the substantive hearing of the Allegation because he was in Nigeria. The Panel noted that the HCPC had sent an email to the Registrant dated 9 January 2019 reminding him that the Suspension Order would soon be reviewed, and asking him for an update. No reply was received. The Panel took into account the potential disadvantage to the Registrant if it were to proceed. However, taking into account the lack of a response or request for an adjournment from the Registrant, the Panel was satisfied that it is in the public interest, as well as being fair, for today’s review to proceed expeditiously, noting in particular that the hearing is a mandatory review of a substantive order which is due to expire on 4 April 2019.
5.The Panel therefore decided to proceed today.
6.The Registrant was employed as a Band 7 Sonographer by the East Lancashire Hospitals Trust ("the Trust") from 1 April 2015. His appointment was subject to a six month probationary period. The Registrant underwent an induction and his first probationary review was held on 3 June 2015 when areas of concern were identified in relation to his skills and practice. He was provided with an action plan with specific tasks for improvement, and it was agreed that there would be additional training sessions provided by staff on the ultrasound system used in the hospital. On 10 June 2015 he was placed on a formal performance management plan because his performance had not improved to a satisfactory level. There was a further meeting on 12 June 2015 when the Registrant was informed that he would be called to a formal hearing regarding his performance. His employment was terminated on 28 July 2015. The Trust subsequently referred the Registrant to the HCPC.
7.At the substantive hearing, which was held on 6 – 7 March 2017, the Panel found impairment by reason of lack of competence, and imposed a Suspension Order for a period of 12 months which came into effect on 4 April 2017. At the first Substantive Order Review on 28 February 2018 the reviewing Panel found the Registrant’s fitness to practise remained impaired, and extended the Suspension Order for a further 12 months.
8.Mr Stephens submitted that, in the absence of any information provided by the Registrant to indicate that he had taken any steps to remediate the identified shortcomings, his fitness to practise is still impaired. Mr Stephens submitted that in the present circumstances, the only sanction which is necessary, appropriate and proportionate is a further period of suspension.
9.There were no representations or information from the Registrant.
10.The Panel accepted the advice of the Legal Assessor.
11.The Panel was aware that its purpose today was to conduct a comprehensive review of the Registrant’s fitness to return to unrestricted practice and considered the HCPTS Practice Notes entitled “Review of Article 30 Sanction Orders”.
12.The Panel must exercise its own independent judgement with regard to impairment.
13.The Panel first considered whether the Registrant’s fitness to practise is currently impaired and took into account the HCPTS Practice Note entitled “Finding that fitness to practise is “Impaired””.
14.In the Panel’s view, the failures found proved are, in principle, remediable. However, there is a lack of any evidence that the Registrant has taken any steps to address his lack of competence. There has been no evidence from the Registrant demonstrating the level of his insight. There is additionally no demonstration of an understanding of the potential impact of his lack of competence on patients, nor is there a demonstration of an understanding of the impact of such action on public perception, or on public confidence in the profession. These factors led the Panel to conclude that there is now, at the present time, a real risk of repetition of his lack of competence in the future. As such, impairment remains on the basis of the personal component.
15.With regard to the public component, the panel was satisfied that the risk of repetition gave rise to a risk of harm to members of the public. In addition, in light of the concerns which have not been addressed, and the lack of engagement in the regulatory process for over two years, the Panel was satisfied that a fully informed and fair minded member of the public would be concerned if the Registrant were returned to unrestricted practice. The Panel was therefore satisfied that the need to maintain public confidence in the profession and to uphold proper standards, would be undermined if a finding of impairment were not made in the particular circumstances of this case.
16.The Panel therefore found that the Registrant’s fitness to practise remains impaired.
17.The Panel next went on to consider sanction, and took into account the Indicative Sanctions Policy (ISP). The Panel bore in mind that sanction is a matter for its own independent judgement, and that the purpose of a sanction is not to punish the Registrant but to protect the public and the wider public interest. Further, sanction must be proportionate, so that any order that it makes be the least restrictive order that would be necessary to protect the public interest, including public protection.
18.The Panel first considered taking no action. The Panel concluded that, in view of the Registrant’s lack of competence which has not been remedied, and the ongoing risk of repetition, it would be inappropriate to take no action. It would be insufficient to protect the public, maintain public confidence and uphold the reputation of the profession.
19.The Panel then considered a Caution Order. The Panel noted paragraph 28 of the ISP which states:
“A caution order is an appropriate sanction for cases, where the lapse is isolated, limited or relatively minor in nature, there is a low risk of recurrence, the registrant has shown insight and taken appropriate action.”
20.The Registrant’s lack of competence was not minor in nature, the risk of repetition is not low, and furthermore, the Registrant has not demonstrated that he has taken any of the steps required to address that lack of competence. Therefore, the Panel concluded that a Caution Order would be inappropriate and insufficient to protect the public and meet the public interest.
21.The Panel next considered a Conditions of Practice Order. Paragraph 33 of the ISP states that:
“Conditions will rarely be effective unless the registrant is genuinely committed to resolving the issues they seek to address and can be trusted to make a determined effort to do so. Therefore, conditions of practice are unlikely to be suitable in cases:
where the registrant has failed to engage with the fitness to practise process, lacks insight or denies any wrongdoing…”
22.On the basis of the Registrant’s lack of engagement there is no indication that he would be willing to comply with conditions. In this regard the Panel noted that the Registrant has not followed the recommendations of previous Panels to submit evidence which may be of assistance to the previous reviewing Panel or to today’s Panel. Nor has he responded to the email to him on 9 January 2019 reminding him of today’s hearing. In addition, the registrant’s failings had continued even after he was given additional support at the hospital. The Panel therefore decided that conditions would be unworkable and therefore neither sufficient to protect the public, nor in the public interest.
23.The Panel next considered a Suspension Order and considered paragraph 39 of the ISP:
“Suspension should be considered where the Panel considers that a caution or conditions of practice would provide insufficient public protection or where the allegation is of a serious nature but unlikely to be repeated and, thus, striking off is not merited”.
24.Further paragraph 41 of the ISP states:
“If the evidence suggests that the registrant will be unable to resolve or remedy his or her failings then striking off may be the more appropriate option. However, where there are no psychological or other difficulties preventing the registrant from understanding and seeking to remedy the failings then suspension may be appropriate.”
25.In light of the Registrant’s continued silence in the face of regulatory proceedings, the panel considered that the registrant is either unable to or unwilling to resolve his failings. However, the Panel was aware that a Striking Off Order was not, in principle, available to it today.
26.The Panel therefore decided that in light of the circumstances before it, a further Suspension Order was the only Order which will provide sufficient public protection as well as be sufficient to uphold the wider public interest. The appropriate length, taking into account the Registrant’s lack of engagement, is 12 months. This new Order is to take effect on expiry of the existing Order.
27.In the Panel’s view, the Panel which reviews the new Suspension Order might be assisted by:
(1)Information about any paid or voluntary work that the Registrant has undertaken since February 2016.
(2)Evidence of any appropriate continuing professional development undertaken since February 2016, in particular to address the shortcomings identified in his practice.
(3)References from any recent employers.
(4)Further reflections from the Registrant which include an indication of how he intends to modify or change his practice to address the shortcomings which have been identified and ensure that they are not repeated.
28.In deciding whether to engage in this fitness to practise process the Registrant should also be aware that at the next review, the Panel will have the power to make a striking-off order.
Upon the expiry of the current period of suspension, namely with effect from 4 April 2019, the Registrar is directed to further suspend the name of Mr Senu T Sejoro from the register for a period of 12 months.
No notes available